Systemic inflammatory response syndrome (SIRS)

May be caused by infection, trauma, tissue injury, pancreatitis, hemorrhagic shock or immune mechanisms.

An inflammatory state affecting the whole body, frequently a response of the immune system to infection.

Criteria: 2 or more of the following-temperature of 38°C

heart rate greater than 90 bpm

respiratory rate greater than 2/min or PaCA <32 mg of mercury

white blood count greater than 12,000 or less than 4000 or > 10% immature bands

Related to systemic inflammation, organ dysfunction, and organ failure.

Systemic inflammatory response is mediated be circulating messenger RNAs which trigger the release of cytokines and the high mobility group box 1 protein leading to excessive activation of leukocytes and endothelial cells.

A subset of cytokine storm, in which there is abnormal regulation of various cytokines.

Closely related to sepsis.

Associated with fever, tachycardia, tachypnea, leukopenia, leukocytosis,and shift to the left, hypotension, organ dysfunction, renal insufficiency, encephalopathy, DIC, and gastrointestinal bleeding.

SIRS criteria are very non-specific.

Causes classified as infectious or noninfectious.

When due to an infection, it is considered sepsis.

Noninfectious causes of SIRS include trauma, burns, pancreatitis, ischemia, hemorrhage, complications of surgery, adrenal insufficiency,pulmonary embolism, anaphylaxis,and drug toxicity.

Treatment is directed towards the underlying process.

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